Document: Notice of Intent to Adopt a Rule, Register Page Number: 28 IR 1199
Source: January 1, 2005, Indiana Register, Volume 28, Number 4
Disclaimer: This document was created from the files used to produce the official CD-ROM Indiana Register.
TITLE 405 OFFICE OF THE SECRETARY OF
FAMILY AND SOCIAL SERVICES
LSA Document #04-321
Under IC 4-22-2-23, the Office of the Secretary of Family and Social Services intends to adopt a rule concerning the following:
OVERVIEW: Amends 405 IAC 1-1-3 and 405 IAC 2-3-10 and adds new rules governing procedures for the automation of
Medicaid spend-down eligibility determinations. Instead of the local Offices of Family and Children manually accounting for the
recipients’ incurred medical expenses and establishing a specific Medicaid effective date each month, providers will submit claims
for medical services rendered to the Medicaid fiscal contractor who will deduct the spend-down amount and pay the claims
accordingly. Will specify conditions under which providers can bill Medicaid recipients for all or part of the spend-down amount.
Will specify procedures for certain types of medical expenses that cannot be handled through the automated process, such as the
recipients’ bills incurred prior to the Medicaid covered period or by non-Medicaid providers, and bills for nonrecipient spouses.
Statutory authority: IC 12-8-6-5; IC 12-15-1-10; IC 12-15-21-2.